What is today?

What is today? Thursday November 14th. Today is just another day, right? No real significance as we wake up and start our morning hurriedly scrambling to shower, make breakfast for the kids, get everyone dressed and ready for school as we go about our usual daily tasks. Looking back I never considered nor pondered the significance of this particular day. Generally we are thankful this time of year as Thanksgiving approaches and we gear up for the holiday season. There are two individuals that I am thankful for that you probably haven’t heard of or know. Their names are Fredrick Banting and Charles Best. Because of these two individuals and their actions ninety-one years ago I am here today along with ten million people just like me. Prior to 1922 my life expectancy, as well as my child’s, was only one to two years at best. Here is what Banting & Charles did for me and my child:
In 1920, Dr. Frederick Banting wanted to make a pancreatic extract, which he hoped would have anti-diabetic qualities. In 1921, at the University of Toronto, along with medical student Charles Best, they managed to make a pancreatic extract. Their method involved tying a string around the pancreas duct. The pancreas was examined several weeks later and the pancreatic digestive cells had died and been absorbed by the immune system. The process left behind thousands of islets. They isolated the extracts from the islet cells and produced isletin. Banting and Best managed to test this extract on dogs that had diabetes. In fact, they managed to keep a dog that had its pancreas taken out, alive throughout the whole summer by administering the extract which was insulin. The extract regulated the dog’s blood sugar levels and within two years a fourteen year old boy was responsive to the treatments which extended his life. (Medical News Today)

TODAY is World Diabetes Day which is acknowledged on November 14th of every year. As stated earlier I am thankful for these two men that set a course where all diabetics can now live a full, happy, and healthy life. I am thankful for the strides that have been made to deal with the daily grind of what can be a life threatening disease. At times diabetes is a disease that cannot be seen but it is felt every minute of every day. Over 25,000,000 people, in the U.S., have diabetes. Only 5% are type 1 diabetics which is when the body produces no insulin. Worldwide there are over 300,000,000 people who have this disease. Diabetes is the 6th leading cause of death (CDC 2010). Below are a few interesting myths and facts about Diabetes from ADA/JDFR:

Myth: Diabetes is not that serious of a disease.
Fact: If you manage your diabetes properly, you can prevent or delay diabetes complications. However, diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke.

Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.
Fact: Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

Myth: Eating too much sugar causes diabetes.
Fact: The answer is not so simple. Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors.

Myth: People with diabetes should eat special diabetic foods.
Fact: A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone.

Myth: Fruit is a healthy food. Therefore, it is ok to eat as much of it as you wish.
Fact: Fruit is a healthy food. It contains fiber and lots of vitamins and minerals. Because fruits contain carbohydrates, they need to be included in your meal plan. An orange is the equivalent of drinking a regular soft drink

Myth: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you’re failing to take care of your diabetes properly.
Fact: For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.

What would you do if your diabetes were cured?

Recently I ran across an online post asking for feedback to the question “What would you do if your diabetes was cured?” To be honest, I have never pondered that type of inquiry as it has not broached my thought process until last week. I struggled with even beginning to narrow it down to one particular item as diabetes is all I have ever known. Nearing almost forty years with this disease I have taken over thirteen thousand (13,000) injections with syringe and insulin pump infusion, have pricked my finger over seventy-five thousand (75,000) times, calculated carbohydrate intake for sixteen thousand (16,000) meals at a minimum, gotten up in the middle of the night due to high or low blood sugar on countless occasions, have become proficient in math calculations, science, psychology and luck in the life of being a Type 1 diabetic. It is a job where diligence is critical twenty-four hours a day, seven days a week year round. I have lived FOURTEEN THOUSAND TWO HUNDRED THIRTY-FIVE DAYS (14,235) without a break. Wow, what a journey this has been!
Would I gorge myself with sweet treats? Fill the pool up with sweet tea and use Reese’s Peanut Butter Cups as a life-raft and a Twizzler for the rope to keep the little kids from getting into the deep end? These are not paid endorsements but should be! Maybe an onion ring would better suffice as a life-saver in this carbohydrate laden pool. Use a Pixie Stick as a straw for an A&W root-beer float? No, I would pass as the sweet tooth fairy no longer visits my house and has not for years. Would I eat a whole pizza consisting of jalapenos, feta cheese, Italian sausage, Canadian bacon and anchovies without suffering the consequences of blood sugars running high for hours on end due to the bread and fat in said pizza? No, give me all those items without the bread and tomato sauce. Would I be able to forego seeing my doctor of endocrinology five times a year, eye doctor and podiatrist once a year? Would I stop going to the pharmacy twelve times a year to pick up life sustaining medicine and medical equipment costing my family thousands of dollars out of pocket every year? No, as I would still have to give diligence to my overall health and make necessary stops to the pharmacy as needed. Would I jump up and down with elation in relief of the mental, emotional and physical toil that consumes every person that faces the challenge of this burden? No, as every person faces undue trial and tribulations at some point during their lifetime.
This has been a journey and I am truly thankful for the friends that I have gained as well as the bond that has been formed due to this disease. I have lost friends due to death at too early of an age.  Even though the journey has been long I am thankful for the experiences I have had and anticpate those of the future. As stated in previous blogs one often hears far-fetched cures that hold little to no merit. There are new strides transpiring in diabetes research happening now and I am thankful for the technological advancements that have already been achieved. This disease has become easier to manage and the potential to put an end to diabetes related blindness, renal failure and appendage amputations is close at hand with the advent of a bionic pancreas and continuing studies in protecting or spurring beta and islet cell functionality. One day soon we could potentially be involved in a feasible solution to exiting the diabetes roller coaster. We are closer today than we were yesterday and rest in the lead car called hope as breakthroughs are developing on a daily basis making the question: “what would you do if your diabetes were cured” more pertinent now than ever before. Writing this blog has helped me formulate a very definitive answer to this query. Were diabetes cured today I would……….hold my nine year old diabetic son in my arms and be thankfully relieved that he would not have to experience the daily grind of this disease. After that I will ask him, “Will you help me fill the pool up with sweet tea?”

My biggest fear has happened to my child…..

As my children have grown older I have discussed the potential risk of them becoming diabetic or their children being diagnosed with diabetes. Why, you may ask? They have lived their lives with me being diabetic. This fear, for me, has been prevalent since the day they were born and I have never wished this disease upon anyone and never will. For some reason my nine-year old son, Connor, and I discussed becoming diabetic as recently as four weeks ago and as usual he had a plethora of questions. Will I become diabetic? Would I be able to get an insulin pump? Do shots hurt? As always I entertained the whimsical questions and answered the query as I always had. “Diabetes is the easiest disease to manage of all the major diseases and it is the one I would want if given a choice.” I never delved into the roller coaster of emotions that one experiences with low blood sugars or the feelings one gets when their blood sugar is too high, the insatiable feeling of thirst or the agitation diabetics frequently experience. Are these symptoms indescribable to one without diabetes? To an extent, yes, because without experiencing the highs and lows for oneself it is very hard to comprehend.

On August 31st I lived one of my biggest fears for one of my children as the day before my family and I set out for an end of summer mini-vacation to see my younger brother, Ben, and his family near Savannah, GA. Over the previous ninety days all of the signs were there but his mother, Amanda, and I chalked them up to feasible conclusions. “My head hurts!” sinuses, I calculated. “I’m thirsty!” football practice will make you thirsty and tired, I surmised. Daily Connor showed signs of being diabetic. I even suspected, as early as May, that he should be tested but all of the events leading up to this day had logical explanations. With the car packed we hit the road and shortly thereafter a little voice in the back seat kept saying “I’M THIRSTY” or “I HAVE TO POTTY”. In the back of mind for a fleeting moment it crossed my thought process that he could be diabetic but that quickly abated as I assumed he was catching a cold. We stopped along the way for Connor to use the bathroom and drink whatever he could get his hands on. After midnight he stated that he had to go to the bathroom really bad and I obliged. “Surely not” I thought to myself. We arrive at our destination and bed down for the evening.  Upon waking Amanda tells me that Connor had an accident while sleeping on the couch. I thought that was highly unusual but probably due to all the water he had consumed. Connor came to me and stated that his head hurt and his nose was running. I give him sinus medication before breakfast and assumed he was coming down with a cold. My son barely touched his breakfast and we were off to tour Savannah. Upon arrival, for our trolley tour, Connor asked for water and the bathroom. A red flag went up in my mind for a fleeting moment. An hour later and we are standing in Paula Dean’s gift shop and my son with a distraught, tired, pitiful look upon his face proceeded to tell me that he had a thirst that he had never felt before. I asked him if he was thirsty enough to drink out of his cousin’s sippie cup and he said yes which raised the red flag higher. I told him that we were about to go eat lunch and that he would feel better if we got food in him. We arrived at The Pirate’s House and were seated for lunch. Connor laid his head on the table and said he did not want anything to eat only something to drink. The red flag was at full mast and alarms went off in my head. I told Amanda that I was going to check his blood sugar. “NOOOOOOO, don’t!” my little boy exclaimed. I had checked his sugar on occasion before as well as my daughters with neither enjoying the finger prick. I did not relent and proceeded. My biggest fear regarding my child’s health had taken place as the glucose meter read 529.

For a brief second I was in disbelief. Surely this was not happening to my son. At the top of my lungs I yelled that we had to get Connor to the emergency room. Amanda was frantic and the restaurant patrons had no idea what was transpiring. I can only imagine what was running through our daughter’s (Brooke) mind or my family’s. I told myself that maybe he had something on his hands. He had touched the bread basket and I thought that is what skewed his numbers. Amanda told me to go wash his hands and I complied. I re-tested him and his blood sugar read 544. Connor was crying because of my reaction as well as his mothers. Thirty-nine years of being a juvenile diabetic flashed before my eyes. The emotional toil that he will encounter, the frustration and the burden he will face daily. That is what hit me more than anything else. I was in denial thinking of every scenario that would cause his blood glucose to be high and knowing there was only one…..diabetes. We rushed outside to await the arrival of the taxi to transport us to Memorial Hospital in Savannah. Connor and I sat on the curb and all I could do was hold him and cry. I apologized to him profusely for carrying my genes telling him that because of me he is now diabetic.
Upon arrival at the hospital Amanda and I had regained some composure for only an instant. We made it back to the emergency room nurse where Amanda and I were asked what was going on with Connor. I broke down as I began to explain our situation to Jennifer Lee the emergency room nurse. Again, I lost my composure and Jennifer proceeded to tell me  “get a grip as little eyes were watching my reaction” and how she understood what we were going through. Really?? Are you kidding me? ……. I proceeded to ask Jennifer if she had diabetes. She said no but she deals with it on a daily basis with her patients. I was flabbergasted and angry. I told her that without having diabetes she had NO IDEA WHAT WE GO THROUGH and that is why I was reacting the way I was. She told me to calm down or she would have me removed. I was dumbfounded but Jennifer was right. I reflected back to the week prior to this happening when I told my now diabetic son how diabetes was the easiest disease to manage. My reaction was speaking a lot louder than my words and I finally realized that fact. Reality set in and my wife and I accepted Connor’s plight. We go on vacation and come home with not one but two diabetics! Before leaving the hospital Connor’s endocrinologist (diabetic doctor) asked him “Connor, what do you think about diabetes?” Without missing a beat Connor stated “Of all the diseases in the world this is the one I want because I can manage it.”

For the first time, I cried about being diabetic.

 As stated in my first blog I am a juvenile diabetic going into my thirty-ninth year.  I was diagnosed in nineteen seventy-four at the age of two.  Diabetes is when the pancreas produces little or no insulin.  Insulin helps turn sugar, in your body, into energy.  Were you to produce or take too much insulin your blood sugar will get too low or if there is not enough insulin your blood glucose goes too high.  Which is better low or high? Neither.  How do I deal with this?  As a diabetic in order to maintain control I test my blood glucose up to ten times a day, count carbohydrates, exercise every day and visit my doctor every three months, at a minimum.  Categorically it is part science, part math, part psychology, biology, and physiology mixed in with a little luck.

I am a little slow in catching up with technology in the field of diabetes.  I gave myself insulin shots for twenty-six years.  The insulin pump was introduced in nineteen-eighty and I did not jump on board until twenty-two years later.  Six or seven years ago the continuous glucose monitor (CGM), which is a device that reads your blood glucose level every five minutes, was introduced and I have eclipsed my first month in wearing one and love it.  You may ask yourself where I am going with this……..the meat of the matter is coming up:

During my pursuit of being in better health and weight loss I frequent my endocrinologist’s (diabetic doctor) office.  At my three month check up, in December, the doctor asked me when I was due for an insulin pump upgrade and told her “I upgraded in September” and asked why?  She stated that there was new technology coming out and that it was a closed loop pump system and that I had to be on a continuous glucose monitoring system in order to get it.  I immediately said that I wanted it and she informed me that she would submit the paper work for the CGM.  A few months went by and I asked several other juvenile diabetics if they had heard about a supposed closed loop “bionic pancreas” with all indicating “no.”  The usual thoughts ran through my head.  Yes, we’ve been hearing this for forty plus years.  Is it some other farfetched pie in the sky pipe dream?  Can diabetes be cured?  No, it would take a successful pancreas transplant and every attempt has failed.  A fellow diabetic told me that what he is hearing is that it is just an insulin pump that would turn itself off when you are low.  My response…..Why would I go to the trouble of getting a cgm if that is all this device can do, what is the point?  I searched the internet high and low for information on the “bionic pancreas” and found very few articles, blogs and writings other than the usual hyperbole.

Then, one day I found a post by someone in my online pump group forum and the title was “Today, I held hope in my hand” written by Moira McCarthy who is a juvenile diabetic parent and volunteer speaker/blogger for the Juvenile Diabetes Research Foundation.  I clicked on it and began to read because it was bionic pancreas/pump related.  Moira recounted her interview with a twenty-two year old female named Anna that was participating in the field/clinical trial experiment of a bionic pancreas at Boston University Hospital.  The date of the blog is only a month or two old.  Moira was having lunch with Anna while she was wearing the actual mechanism and asked to hold the machine that would give her insulin, check her blood sugar and correctly react according to her glucose readings.  At lunch Anna consumed a potato-pasta meal that would wreck any diabetic’s blood glucose levels and be hard to control. Moira wrote that Anna’s blood glucose remained in the eighties which is the level that a non-diabetics  blood sugar would be.  Here is what Anna relayed to Moira McCarthy regarding her experience:

“While I was in the trial, the trouble-shooting went away. Completely away. And because of that, (listen to what she says here carefully folks: this is really something to grasp) I had no guilt. I had no shame. I was forced to give all that up to technology. And man, it worked and it felt good.”  After the trial ended Anna was asked how she felt about the bionic pump and responded:  “I would wear 10 sites in my body if it meant the emotional toll of diabetes was stripped away from me like it was last week,” she said. “I would give up every asset I have to buy that thing tomorrow.”

Moira blogged:  “Guilt. Shame.  Frustration. My friends; THESE are the complications of diabetes that few consider. These are the effects that crush souls of some and challenge the mental health of others. These are the complications we can CURE and cure soon. I know, a smart pump or APP or bionic pancreas or whatever you want to call it will bring people with T1D better physical health. If we can create a tool that keeps most people’s a1c’s below even 7, we are probably looking at a world where kidney transplants, blindness and other such things are of the past. But even if all it ABSOLUTELY does is remove that guilt, that shame, that anger, that frustration from lives …. I’m so completely, completely in.”

 

Those words rocked me to my foundation.  They struck me like a bolt of lightning. Guilt, frustration, shame, anger, sadness and the roller coaster we ride daily…..these are the mental aspects that people do not and cannot realize or grasp unless they have experienced diabetes.  My whole life, as a diabetic, was summed up in those words and I did not realize it until reading McCarthy’s blog.  In all of my years being on this earth, I have never considered diabetes as a disease or as a burden because this is all I have ever known.   I attribute my view of diabetes to my mother because I was raised by an individual that went through the aforementioned emotions, worried about me and never showed me the anguish that she experienced.  As an adult I have a greater appreciation for the wonderful foundation she laid for me.  I thought of her as Moira McCarthy stated “Today, I held hope in my hand.”  I came to the realization that this is actually happening and I may be able to experience this in my life time.  For the first time, I cried about being a diabetic.  – Derek Raulerson

 

I have entered …

I have entered the blogging world! Why? I have no idea. I wanted an avenue to document the journey I am about to take. I am forty-one years old and a juvenile diabetic diagnosed at the age of two in 1974. In good health, as far as I can tell, and recently shed forty-seven pounds off my 5 foot 7 frame. At the age of forty I ballooned to two hundred pounds for the first time in my life. Why? Multiple factors. I was in the process of running for mayor in my local city. I was elected to public office back in 2008 and served as a city councilor. The four years I was in office I put on forty-seven pounds!! Eating out, all the time, stress, diabetes (which was semi-controlled) led to me fluffing up.

On my fortieth birthday I made the decision that I would make a life change. I came to the realization that I would make the necessary adjustments to have better control of my diabetes and shed the pounds.  I kept telling myself that I would do it and never started until I hit the ripe old age of forty.  Determined, I committed an hour a day of physical movement. I started walking the neighborhood which led to walking the Chief Ladiga Trail. I walked as late as eleven o’clock, at night, and as early as five in morning. Movement, movement, movement!!! That’s what I had to do.

This led to me paying attention to what I was eating which led to less insulin intake and lowered blood sugar.  The hardest part were the first three weeks but, once I got through the initial withdrawal of consuming less carbs it became easier. I stepped on the scales daily, which is not a good idea as my weight fluctuated each time.  I decided to change my weigh-ins to once a week.  Slowly and surely I began shedding the pounds! I averaged losing four pounds a week.

People I interacted with, daily, began noticing the change and people who I had not seen, in a while, really did not notice. I began feeling better about myself and became more confident that I could accomplish my goal of getting to my target weight of one hundred fifty-five pounds which is the high-end of my target weight based on my height.  My Hemoglobin A1c, which is a blood test that shows your ninety day blood sugar average, had always been below seven but it was due to low blood sugars which can skew your results.  A normal person’s A1c is 4 to 5 with their blood sugars being running around eighty-three.  Ideally diabetics should be below seven which is an average blood glucose reading of 140.  At my last doctor’s appointment my A1c was 5.9 which is great but I was expecting a 5.5! My doctor said “Derek, you are harder on yourself than I am.”  After hearing my doctor make that statement I smiled and said “Yes! I have been at this for thirty-nine years and have gotten by without bearing down on the disease that could lead to an early death.  I took control and am thankful for this opportunity to be healthier and fit. I feel better now, at the age of forty-one, than I did in my teens. I will continue to press on. Each day has its own challenges and I look forward to every new beginning.

Dreams do not h…

Dreams do not haunt me. Failing to pursue them does.